ADVERS ETKI BILDIRIM FORMU

In case of any side effect related to the products of Medicheck Nükleer Ürünler A.Ş., you can report such effects to Turkish Pharmacovigilance Center (TÜFAM) (www.titck.gov.tr, e-mail: tufam@titck.gov.tr, phone: 0 800 314 00 08, fax: 0 312 218 35 99) by calling 0 212 716 53 45 or by completing the form below. By means of reporting any side effects observed, you will have contributed to ensuring that further information is obtained about the safety of the medicine you are using.

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Please provide your phone number or other contact details to allow us to contact you in relation to your Side Effect/Undesired Effect/Adverse Effect report. All details you have shared with us shall be kept confidential, and shall not be shared with any third party or company other than the institutions and organizations with whom they should be shared pursuant to the legal regulations and procedures on patient privacy. By means of checking the "I Agree" box upon reading our Medicheck information notice and consent letter regarding the reporting of Side Effects/Undesired Effects/Adverse Effects, you will be deemed to have accepted the storage, retention and processing of your personal data. Please note that by checking the "I Agree" box, you also agree and declare that you accept the legal warning and that the information you entered are accurate.